초록
Background: Arterial stiffening may affect regional myocardial function in hypertensive patients with normal ejection fraction (EF). Methods: Brachial-ankle pulse wave velocity (PWV) was measured in 70 patients, of mean age $48{\pm}14$ years, with untreated hypertension and EF > 55%. Using two-dimensional-speckle tracking echocardiography, we measured longitudinal and circumferential strain (${\epsilon}$) and strain rate (SR). Basal and apical rotations were measured using short axis views. Results: The mean systolic and diastolic blood pressure in these patients was $152{\pm}15mmHg$ and $92{\pm}11mmHg$, respectively. The mean value of PWV was $1578{\pm}274cm/s$. PWV significantly correlated with age (r = 0.682, p < 0.001), body mass index (r = -0.330, p = 0.005), systolic blood pressure (r = 0.386, p = 0.001) and pulse pressure (r = 0.509, p < 0.001). PWV also significantly correlated with septal E' velocity (r = -0.570, p < 0.001), E/A ratio (r = -0.414, p < 0.001), E/E' ratio (r = 0.589, p < 0.001), systolic global longitudinal ${\epsilon}$ (r = 0.300, p = 0.012) and early diastolic SR (SRE) (r = -0.479, p < 0.001) suggesting impaired abnormal relaxation. PWV was also correlated with basal rotation (r = -0.301, p = 0.011) and basal-toapical twist (r = -0.256, p = 0.032). The increases in apical rotation and basal-to-apical twist were attenuated in patients with PWV > 1700 cm/s compared to those with PWV ${\leq}1400cm/s$ or those with PWV 1400-1700 cm/s. Conclusion: In hypertensive patients with normal ejection fraction, arterial stiffening contributes to impaired systolic and diastolic function of the regional myocardium. Compensatory increases in ventricular twist were diminished in patients with advanced stage of vascular stiffening.
